White Coat Underground

Of course you know what my answer will be. It was predictable that the death of a girl shortly after receiving an HPV vaccine to prevent cervical cancer would attract the immoral agents of the anti-vaccine movement. Like zombies to brains, they descend on the tragedy, ready to consume it and gain strength. And just as zombies will eat anything cerebral, even Dana Ullman’s brains, the fact that the vaccine didn’t cause the death won’t slow them down a bit. (Have I finished straining the zombie analogy? Maybe…)

The media certainly loves this story. What could be better than a poor, innocent young girl dying from a shot given to allow her to engage in immoral behavior and avoid God’s judgment? Or something like that. Here’s what the Philadelphia Enquirer said:

HPV Vaccine Death Raises Wider Issue

Whoa! Stop right there! “HPV vaccine death?” Are you sure about that? What about “she wore a pink shirt that day death?” Morons.

The death of a 14-year-old British girl hours after she received the Cervarix vaccine that protects against human papilloma virus, the virus that causes cervical cancer, shows how difficult it can be to assess the risk of vaccines. The problem is especially timely now because of widespread fears about the supposedly untested vaccine against the pandemic H1N1 influenza virus.

Arghh! Not only are they incorrectly and immorally exploiting a tragedy, they are trying to extend the fear to the swine flu vaccine. How horrid. Well, they go on to try to correct some misconceptions about the flu shot, but they can’t keep their ghoulish claws off this poor British girl:

As for the British girl, it’s possible she died from an adverse reaction to Cervarix.

It’s also possible she died from the malignant tumor growing in her chest, as the pathologist found. Undoing the damage of articles like this isn’t always possible, even with a follow up correction piece. They should be ashamed.

Comments

#1 Jared
October 2, 2009

I find it amazing how quickly this was picked upon by the anti-vaxers. It’s almost like they have a script for this type of thing.
#2 D. C. Sessions
October 2, 2009

Is anyone surprised that John “Whale” Scudamore is now insisting that the Home Office pathologist who performed the autopsy was engaged in a coverup, and that even if he were shown the tumor or even a video of the autopsy, he wouldn’t believe it?
#3 Denice Walter
October 2, 2009

I’m thinkung the new DSM should include a new phobia or delusional disorder concerning vaccines and/or toxins.
#4 James Pannozzi
October 2, 2009

PalMD: Could you make some comments on the decision by Gov. Patterson of New York to require mandatory swine flu vaccinations for Doctors, nurses and other health pros?

Pardon me if you have already commented on this.
#5 skepville
October 2, 2009

Unfortunately, this story went mass media right away. I think I heard it on NPR. The Canada vaccine story was also disseminated by NPR.
#6 JillWinters
October 2, 2009

While I agree with you about the bad reporting, the need to watch very closely whether the HPV vaccine is doing more harm than good is pressing.

According to analysis of FDA reports, as of early 2008, there have been 8864 reports of complications associated with HPV vaccinations. 38 reports of Guillain-Barre syndrome and 18 potentially related deaths. While, yes, of course these deaths could have been due to myriad other causes, IF Gardasil is implicated, the death rate associated with the vaccine is the same order of magnitude as the deaths attributed to cervical cancer itself.

18 deaths, assuming 1 million women vaccinated (couldn’t find the numbers on this, ballpark) = 0.002% death rate.
4000 cervical cancer deaths per year, 100 million women at risk in the US (there are 150M females, but I scaled it down) = 0.004% death rate

Add to that the federal cost of mandating this vaccine, estimated at least $2B, we SHOULD be asking some very serious questions about an HPV vaccination program. Would increasing the availability of pap smears to lower income women or otherwise bolstering awareness and screening campaigns be a better alternative, in terms of cost, effectiveness, and safety? I don’t know, but I think it’s a question worth asking and one that doesn’t seem prominent in the discussion.

There are also issues associated with prescreening patients (vaccine has been found to make existing HPV cases much worse) and the risk that women who get the vaccine will think regular pap screenings are unnecessary and potentially nullify the preventative benefits of the vaccine.

I am a woman who has been diagnosed with the early stages of cervical cancer. I support anything that can prevent another woman from going through the same experience, but I am watching the fast-tracking of Gardasil with a very wary eye.

And I’m sorry, I’ve been intermittently following your blog for a while now and I have to say it:

your self-righteousness is going to do absolutely nothing, in my opinion, to alleviate the bad reporting or other issues that you feel so strongly about. If your objective is to try to get patients in the US to be critical consumers of their medical care, I think the vitriolic language and attitude you consistently convey will only serve to alienate a large portion of them and result in failure of your goal. If, however, your objective is to feed the ego of yourself and your similarly arrogant followers, then I think you have achieved wild success.

Shame on YOU for making this issue about how right you are rather than being about the full story of HPV vaccinations.
#7 PalMD
October 2, 2009

It takes a stunning level of intentional ignorance to conflate VAERS reporting data with vaccine safety. How is that for eschewing obfuscation?
#8 Igor
October 2, 2009

“Shame on YOU for making this issue about how right you are rather than being about the full story of HPV vaccinations. ”

If you truly have been following this blog for quite some time, you would know that PAL addressed the issue of VAERS reporting and the safety of HPV vaccination on more than one attention and in quite a detail. Pointing out an egregious error that, if perpetuated, affects thousands of lives is not the same as gloating. In fact, from years of reading this blog, I know that PAL would be a much happier person if extreme examples such as this one did not demonstrate the need for science based medicine and diligent reporting on same.
#9 PalMD
October 2, 2009

Add to that the federal cost of mandating this vaccine, estimated at least $2B, we SHOULD be asking some very serious questions about an HPV vaccination program. Would increasing the availability of pap smears to lower income women or otherwise bolstering awareness and screening campaigns be a better alternative, in terms of cost, effectiveness, and safety? I don’t know, but I think it’s a question worth asking and one that doesn’t seem prominent in the discussion.

This has actually been a prominent part of the discussion of Gardasil, as has Merck’s unethical and unwise campaign to promote this otherwise very useful pharmaceutical. Some links of interest:

http://scienceblogs.com/denialism/2008/07/should_parents_worry_about_hpv.php

http://scienceblogs.com/denialism/2008/03/gardasil_is_a_good_idea.php

http://scienceblogs.com/denialism/2008/07/the_stupid_contuines_at_channe.php

http://scienceblogs.com/whitecoatunderground/2009/04/sit_right_down_and_well_speak.php

But perhaps it’s time to write a fresh piece on the topic.
#10 Igor
October 2, 2009

*attention = occasion

I’ve been at work too long.
#11 JillWinters
October 2, 2009

“If you truly have been following this blog for quite some time, you would know that PAL addressed the issue of VAERS reporting and the safety of HPV vaccination on more than one attention and in quite a detail.”

As stated, I”ve been intermittently following. If I missed a previous focus on this issue, my apologies. A quick search of the archives however, yielded nothing.

“Pointing out an egregious error that, if perpetuated, affects thousands of lives is not the same as gloating.”

As stated, I agree with PalMD completely on the bad reporting. My contention is with the rampant namecalling and supercilious attitudes observed in the posts and comments on this blog. While I am sure that repeatedly witnessing the egregious reporting on medical issues must be infuriating for a medical expert, calling the writers at the Philadephia Enquirer ‘morons’ is not, in my mind, in any way productive, professional, or respectful.

If PalMD really wants such reporting to change, perhaps he can send a message to said newspaper and point out how it was inaccurate. And perhaps he already has done so. I just had to comment because I find so much of the discussion on the blog useful and thought-provoking, but I often find the tone and the insults, completely distasteful and, in my opinion, ineffective to stated overall goal. It really seems that often the author and readers get some joy out of deriding woo-sayers and that followers of the blog seem to be anxious to pat themselves on the back for how many times they can call the other side idiots, rather than actually having a dialogue and trying to open some minds, on both sides. The contempt and disdain is really not going to move the issue forward.
#12 ttabetic
October 2, 2009

HAHAHAHAHA!!!

Yeah, Pal, write right, asshole!!
#13 Annon
October 2, 2009

Don’t miss the book “The HPV Vaccine Controversy: Sex, Cancer, God and Politics” authored by Shobha S. Krishnan, M.D, Barnard college, Columbia University. It is written without the influence of any pharmaceutical companies or special interest groups. The book educates both professionals and the public about HPV infections, the diseases they cause and the role/ controversies surrounding the new vaccines. The Journal of the American Medical Association (JAMA, June 17th 2009) calls the book superb and a terrific contribution to the field. It is available at amazon.com, Barnes and Noble .com and through international distributors. Link to the book: http://www.greenwood.com/catalog/C35011.aspx
#14 Igor
October 2, 2009

Respect and civility are reserved for respectful and civil. In the ideal world the issues and people who mandate such barbaric decorum would simply not exist. PAL’s occasionally uncouth remarks remarks are a symptom of a greater malady that is the willfully ignorant and occasionally malevolent debuakist.

See Kill, I can sound pedantic without any substantive criticism, too.
#15 BaldApe
October 3, 2009

“Innocent woman, age 85, dies as a result of HPV vaccine administered to her as teenager.”
#16 BVZ
October 5, 2009

@Post 6:

The question is, what would the 0.004% (the percentage of woman dying from cervical cancer) be if NO ONE WAS VACCINATED. It does not make sense comparing the amount of woman dying from the vaccine with the amount of woman dying from what the vaccine prevents, since the vaccine DECREASES the amount of deaths.

In fact, using this logic, the better a vaccine works, the worse it becomes. If a vaccine works extremely well, LESS woman die, until more woman die from the vaccine itself than from the disease prevented by the vaccine.

What now? Do you want the vaccine to be used LESS, so that the number of woman dying from the disease is greater than the deaths caused by the vaccine again?

Once it has been determined that the odds of dying from cervical cancer is greater than dying from the vaccine, there is no reason not to be vaccinated.
#17 saari
October 5, 2009

one measure of the effectiveness of a vaccine is the number of deaths avoided. if the death rate from vaccine (this isn’t established for hpv vaccine by the way, but for the sake of argument) is roughly the same as the number for the disease itself, then the benefits of the vaccine are clearly not worth the risk. you could be just trading one type of death for another.

and even if the death rate from the disease is higher, vaccination still might not be the best choice if a good portion of the deaths could be prevented using lower risk alternatives, such as increased pap testing.

this discussion has also not addressed the potential and unknown long-term effects of vaccination.